• Title/Summary/Keyword: mortality risk

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Designing a life actuarial model with reflection of mortality differential by marital status (혼인상태별 사망률의 차이를 반영한 생명보험수리 모형의 설계)

  • Kwon, Hyuk Sung;Kim, Jung Eun
    • Journal of the Korean Data and Information Science Society
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    • v.24 no.3
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    • pp.571-584
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    • 2013
  • Various risk factors other than age and sex affecting human mortality have been identified and quantitatively analyzed by previous studies in many area of research. Marital status is one of key mortality risk factors which affect life expectancy directly or indirectly. Relevant results have implication on risk management for both of social and private insurance. In this paper, a mortality model to reflect mortality differential according to marital status and possible transitions among marital status is designed. Various actuarial calculations were performed and related issues were discussed.

Clinical Study and Risk Factors of Surgical Mortality of Congenital Heart Defects (선천성 심장기형의 임상고찰 및 수술사망율에 미치는 위험인자의 분석)

  • 이상호;김병균
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.17-26
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    • 1997
  • Objeitives. The surgical mortality of congenital heart defects has been reduced (or the very young age group. Especially, young age at repair is an important risk factor for mortality after repair of tetralogy of Falloff. Some risk factors were analyzed Methods. Three hundred and sixty six patients underwent surgical Intervention. Ages ranged from 5 days to 64 years, and 80 patients were adults(over 15 years of age). The defects consisted of 313(84.2%) acyanotic and 53(15.8%) cyanotic anomalies. The surgical mortalities were evaluated by univariate and multivariate analysis. Results. The overall surgical mortality was 10.4%. Mos deaths occurred in the infant group younger than 6 months(20/38 deaths) and in cyanotic group(21/38 deaths). Surgical infant mortality younger than 12 months was 24.8%(25/101). Risk factors of mortality in open heart surgery were age(p< 0.0001), body weight(p< 0.0001), pump time(p< 0.0001), aortic cross clamp time(p< 0.0001), use of total circulatory arrest(p<0.0001) and cyanotic disease(p<0.0001) by univariate analysis. But by multivariate analysis, the risk factor of mortality in open heart surgery was disease entity(p=0.002) only. A disease group with the highest risk was a cyanotic group(odds ratio was 15.3 relative to ventricular septal defect) excluding tetralogy of Falloff(odds ratio=0.27). Conclusions. Even though the most important risk factor was disease entity, we should conentrate our efforts on the technically improvable factors affecting surgical mortality indicated by univarlate analysis.

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Estimating the Willingness-to-Pay and the Value of a Statistical Life for Future Mortality Risk Reduction : The Value of a Statistical Life for Assessing Environmental Damages and Policies (미래의 사망가능성 감소에 대한 지불의사금액과 통계적 인간생명의 가치 측정 -환경적 피해와 환경정책의 평가를 위한 통계적 인간생명의 가치-)

  • Shin, Young Chul;Joh, Seunghun
    • Environmental and Resource Economics Review
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    • v.12 no.1
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    • pp.49-74
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    • 2003
  • This study used a slightly modified version of contingent valuation questionnaire designed and developed by Krupnick et al.(2000) to estimate the value of mortality risk reduction for environmental policy. Because that environmental policy, especially air pollution policy with some latency main effect on mortality risk reduction of old people with some latency period, respondents were asked about their current WTP for 5/1,000 mortality risk reduction being to take place beginning at 70 over the course of ten years. The annual mean WTP is 233,370 won (standard error 32,570 won) in spike/continuous/interval data model. The implied VSL is 466 million won. The 95% confidence interval is 339 million won~594 million won.

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Suitability of stochastic models for mortality projection in Korea: a follow-up discussion

  • Le, Thu Thi Ngoc;Kwon, Hyuk-Sung
    • Communications for Statistical Applications and Methods
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    • v.28 no.2
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    • pp.171-188
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    • 2021
  • Due to an increased demand for longevity risk analysis, various stochastic models have been suggested to evaluate uncertainly in estimated life expectancy and the associated value of future annuity payments. Recently updated data allow us to analyze mortality for a longer historical period and extended age ranges. This study followed up previous case studies using up-to-date empirical data on Korean mortality and the recently developed R package StMoMo for stochastic mortality models analysis. The suitability of stochastic mortality models, focusing on retirement ages, was investigated with goodness-of-fit, validity of models, and ability of generating reasonable sets of simulation paths of future mortality. Comparisons were made across various types of models. Based on the selected models, the variability of important estimated measures associated with pension, annuity, and reverse mortgage were quantified using simulations.

Acute Pulmonary Embolism: Clinical Characteristics and Outcomes in a University Teaching Hospital (한 대학병원에서 급성 폐색전증으로 진단된 환자들의 임상적 특성 및 예후)

  • Chae, Jin-Nyeong;Choi, Won-Il;Park, Jie-Hae;Rho, Byung-Hak;Kim, Jae-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.3
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    • pp.140-145
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    • 2010
  • Background: Pulmonary embolism (PE) is a common clinical problem in the West that is associated with substantial morbidity and mortality. The diagnostic modality has been changed since 2001. This study retrospectively reviewed the PE mortality with the aim of identifying the risk factors associated with mortality since the multidetector computed tomography (MDCT) was introduced. Methods: We analyzed 105 patients with acute PE proven by multidetector CT or ventilation perfusion scan. The primary outcome measure was the all-cause mortality at 3 months. The prognostic effect of the baseline factors on survival was assessed by multivariate analysis. Results: The main risk factors were prolonged immobilization, stroke, cancer and obesity. Forty nine percent of patients had 3 or more risk factors. The overall mortality at 3 months was 18.1%. Multivariate analysis revealed low diastolic blood pressure and the existence of cancer to be independent factors significantly associated with mortality. Forty two PE patients were examined for the coagulation inhibitors. Four of these patients had a protein C deficiency (9.5%), and 11 had a protein S deficiency (26%). Conclusion: PE is an important clinical problem with a high mortality rate. Close monitoring may be necessary in patients with the risk factors.

Mortality Risk by Living Arrangements among Old Adults: Comparison between Living with Others and Living Alone (노인의 거주형태에 따른 사망 위험요인: 동거노인과 독거노인의 비교)

  • Lee, Si-Eun
    • Journal of Digital Convergence
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    • v.18 no.9
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    • pp.249-256
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    • 2020
  • This study was to identify differences in mortality risk by living arrangements among older adults. We analyzed data from 3,827 older adults who took part in the 2014 Korean Longitudinal Study of Aging. Cox proportional hazards regression was used for data analysis. The significant factors associated with mortality risk in living with others were male, education level, self-rated health, limitation of instrumental activities of daily living, cognitive dysfunction, and depression. The significant factors associated with mortality risk in living alone were regular exercise, limitation of instrumental activities of daily living, and cognitive dysfunction. This study is significant in that it examined whether there are differences between mortality risk by living arrangements. According to the results of this study, nursing intervention should be developed to decrease mortality by living arrangements.

Differential Signature of Obesity in the Relationship with Acute Kidney Injury and Mortality after Coronary Artery Bypass Grafting

  • Moon, Hongran;Lee, Yeonhee;Kim, Sejoong;Kim, Dong Ki;Chin, Ho Jun;Joo, Kwon Wook;Kim, Yon Su;Na, Ki Young;Han, Seung Seok
    • Journal of Korean Medical Science
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    • v.33 no.48
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    • pp.312.1-312.10
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    • 2018
  • Background: Obesity is related to several comorbidities and mortality, but its relationship with acute kidney injury (AKI) and long-term mortality remain undetermined in patients undergoing coronary artery bypass grafting. Methods: Data from 3,018 patients (age ${\geq}18$ years) who underwent coronary artery bypass graft surgery from two tertiary referral centers were retrospectively reviewed between 2004 and 2015. Obesity was defined using the body mass index, according to the World Health Organization's recommendation. The odds and hazard ratios in post-surgical, AKI, and all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed for $90{\pm}40.9$ months (maximum: 13 years). Results: Among the cohort, 37.4%, 2.4%, 21.1%, 35.1%, and 4.0% of patients were classified as normal weight, underweight, overweight-at-risk, obese I, and obese II, respectively. Post-surgical AKI developed in 799 patients (26.5%). Patients in the obese groups (overweight-at-risk to obese II) had a higher risk of AKI than did those in the normal-weight group. During the follow-up period, 787 patients (26.1%) died. Underweight patients had a higher risk of mortality than did normal-weight patients, whereas overweight-at-risk, obese I, and obese II patients showed better survival rates. Conclusion: After coronary artery bypass graft surgery, obese patients encountered a high risk of AKI, and underweight patients exhibited a low chance of survival. Awareness of both obese and underweight statuses should be raised in these patients.

Anemia as a Risk Factor of Mortality and Rehospitalization in Patients with Heart Failure : An Integrative Review (심부전 환자의 빈혈과 사망률 및 재입원 간의 관계에 대한 통합적 고찰)

  • Son, Youn-Jung;Kim, Bo-Hwan
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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    • pp.94-108
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    • 2019
  • Purpose : Heart failure (HF) is considered an important medical burden with rehospitalization and mortality. Anemia is a major risk factor associated with the severity of HF. To improve the understanding of the impact of anemia in the population with HF, we explored the prevalence of anemia, its guidelines, relationship between anemia and mortality or rehospitalization, and limitation of reviewed papers of various populations with HF. Method: We used Whittemore and Knafl's integrative review methodology (2005), and thirty research papers were analyzed. PubMed, CINAHL, Cochrane, PsychInfo, Embase, Web of Science were searched for papers published between January 1960-June 2018. Results: Anemia in individuals with HF was primarily defined using the World Health Organization guideline. The prevalence of anemia in patients with HF varied from 9% to 56.7%. Moreover, such a condition significantly increases the prevalence of mortality or rehospitalization in patients with HF. The analyzed majority were non-prospective cohort study including secondary data analysis. Conclusion: Anemia in individuals with HF is a significant risk factor of mortality and rehospitalization. Prospective cohort studies should be designed to identify the optimal value for screening anemia and the impact of anemia on rehospitalization and mortality among HF patients.

Adverse Effects of Air Pollution on Pulmonary Diseases

  • Ko, Ui Won;Kyung, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.313-319
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    • 2022
  • Environmental exposure to air pollution is known to have adverse effects on various organs. Air pollution has greater effects on the pulmonary system as the lungs are directly exposed to contaminants in the air. Here, we review the associations of air pollution with the development, morbidity, and mortality of pulmonary diseases. Short-and long-term exposure to air pollution have been shown to increase mortality risk even at concentrations below the current national guidelines. Ambient air pollution has been shown to be associated with lung cancer. Particularly long-term exposure to particulate matter with a diameter <2.5 ㎛ (PM2.5) has been reported to be associated with lung cancer even at low concentrations. In addition, exposure to air pollution has been shown to increase the incidence risk of chronic obstructive pulmonary disease (COPD) and has been correlated with exacerbation and mortality of COPD. Air pollution has also been linked to exacerbation, mortality, and development of asthma. Exposure to nitrogen dioxide (NO2) has been demonstrated to be related to increased mortality in patients with idiopathic pulmonary fibrosis. Additionally, air pollution increases the incidence of infectious diseases, such as pneumonia, bronchitis, and tuberculosis. Furthermore, emerging evidence supports a link between air pollution and coronavirus disease 2019 transmission, susceptibility, severity and mortality. In conclusion, the stringency of air quality guidelines should be increased and further therapeutic trials are required in patients at high risk of adverse health effects of air pollution.

Selection of Priority Areas Based on Human and Economic Risk from Exposure to Fine Particles in Seoul (서울 대기 중 미세 먼지 노출로 인한 위해도에 근거한 우선 관리 지역 선정 -이론적 사망 위해도 및 손실비용을 근거로-)

  • Kim Ye-Shin;Lee Yong-Jin;Shin Dong-Chun
    • Environmental Analysis Health and Toxicology
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    • v.19 no.1
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    • pp.49-58
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    • 2004
  • It is important to select a risk based priority area for environmental policy formation and decision-making. We estimated the health risks and associated damage costs from exposure to fine particles and assigned priority areas for twenty -five districts in Seoul. In order to estimate the theoretical mortality incidence of the health risk, baseline risks were estimated from mortality rates in two low level areas of fine particles, Seocho Gu and Cheju city To estimate the damage cost from the risk estimates, we investigated and estimated the willingness to pay (WTP) for specific risk reduction. We assumed two different locations as the reference area, Cheju city as Scenario I and Seocho gu as Scenario II. From the results, the five districts, Kwangjin, Chungnang, Kangbuk, Nowon, and Kangnam, ranked high in the categories of both health risk and economic risk. Damage costs were over twenty billion won in each of these districts. As there are uncertainties in these results, the parameter values such as PM$_{2.5}$ level, dose -response slope factor, baseline risk, exposure population and WTP should be continuously validated and refined.d.